Adenocarcinoma of the Cervix
Common sites:
Gross features:
Histologic
features:
- areas
of microinvasion:
- finger-like
extension of epithelium with abundant pink cytoplasm into the stroma from a gland showing AIS
- small
detached tumour cell islands adjacent to AIS
that elicit a stromal response
- closely
packed collections of glands that have lost their smooth outlines
- dilated
glands with complex cribiform or papillary
growth patterns
- stromal response may be absent
- invasive-appearing
glandular arrangement
- glands
of invasive adenocarcinoma:
- complex,
racemose, glandular pattern
- complex
papillary projections projecting into glandular lumens
- stratified
epithelial cells
- mucin in the stroma forming lakes or pools
- cellular
features:
- nuclear
atypia, pleomorphism
- coarsely
clumped chromatin
- prominent
nucleoli
- numerous
mitoses
- adenoma
malignum
- benign-appearing
glands
- nuclei
slightly larger than normal
- haphazard,
infiltrative architecture is most useful clue
- do
not tolerate any glands deeper than 2/3 of thickness of cervical wall
- desmoplastic/stromal
reaction may be present
Immunophenotype:
|
Marker:
|
Sensitivity:
|
Specificity:
|
|
Mucin
|
|
not good
|
|
CEA
|
80%
|
Not great
Uterine CA
usually neg
|
|
P16
|
|
|
|
Vimentin (neg)
|
|
|
|
ER/PR (neg)
|
|
|
|
IC5
|
90%
|
good
|
Molecular features:
Other features: